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Epigenetics

Several weeks ago, a new magazine appeared in my waiting room. It is called GENOME. It is also available online at genomemag.com. It is an interesting science magazine written for the general public and it features articles about genetics and cutting edge medicine. Just the ads from various cancer labs and hospitals will blow your mind. The Fall 2015 issue features an article entitled, Traces of the Past, concerning the emerging field of epigenetics. Epigenetics refers to molecular processes that leave durable marks on our DNA, altering the gene's functioning independent of the DNA sequence.  If our genes are the instructions, then the epigenome is the punctuation. Some have likened the epigenome to software and the genome to computer hardware.

New Blood Pressure Guidelines

In December 2013 an expert panel on hypertension published its latest recommendations in the Journal of the American Medical Association. In essence these are the recommendations:  1. The target BP for patients over 60 is now 150/90. It used to be 140/90.  2. There is insufficient evidence to support a target systolic blood pressure for people under the age of 60.  3. Reduction of one risk factor (in this case hypertension)  for heart attacks, strokes and premature death by using a drug does not in and of itself mean that patients are less likely to suffer these events. These recommendations make sense to me because as we age, the compliance of our blood vessels decreases, they become less flexible and our blood pressure rises over time. To try and maintain an otherwise healthy patient over 60 to a BP of 120/80 never made much sense to me. 

Fix Your Knee With A Therapeutic Shoe

Family Practice News reported on May 1, 2013 that two doctors at Rush University in Chicago invented a new type of shoe which decreases symptoms in patients suffering from osteoarthritis of the knee. This is not an orthotic, rather the sole is designed with strategically placed grooves which mimic walking barefoot. Wearing the shoes, at least 6 hours a day, six days a week lead to an 18% reduction in the load on the knees. This invention supports the osteopathic concept of treating the foot and ankle as part of the treatment of the knee.